_Aims:_ Cognitive and behavioral treatments (CBT) for sleep problems and chronic pain have shown good results, although these results could improve. More recent developments based on the psychological flexibility model, the model underlying Acceptance and Commitment Therapy (ACT) may offer a useful addition to traditional CBT. The aim of this study was to examine whether an ACT-based treatment for chronic pain is associated with improved sleep. Secondly, we examined the associations between changes on measures of psychological flexibility and sleep-related outcomes. (...) _Methods:_ The study used an observational cohort methodology. Participants were 252 patients (73.8% female) attending a 4-week, interdisciplinary, pain management program in London, United Kingdom. Participants completed standard self-report measures of pain and functioning, sleep outcomes, and processes of psychological flexibility. Pre- to post-treatment, and pre-treatment to follow-up measures were examined for statistically significant differences using paired samples t -tests. Secondarily, hierarchical multiple regression analyses were conducted to examine change in process measures in relation to change in treatment outcome. _Results:_ Participants showed statistically significant improvements (all p d = 0.45), sleep interference ( d = 0.61), and sleep efficiency ( d = 0.32). Significant improvements in insomnia severity and sleep interference were also observed at 9-month follow up. Small to medium effect sizes were observed across the sleep outcomes. Statistically significant changes were also observed on measures of psychological flexibility, and these improvements were significantly associated with improvements on sleep-related outcomes, independently contributing up to 19% of unique variance. _Conclusion:_ This study supports the potential usefulness of ACT-based treatments for chronic pain for addressing co-occurring sleep difficulties. Further research is needed to determine how to improve the impact of this treatment for co-morbid pain and sleep difficulties, possibly using a randomized-controlled trial design. (shrink)

Genome editing enables very accurate alterations to DNA. It promises profound and potentially disruptive changes in healthcare, agriculture, industry, and the environment. This paper presents a multidisciplinary analysis of the contemporary development of genome editing and the tension between continuity and change. It draws on the idea that actors involved in innovation are guided by “sociotechnical regimes” composed of practices, institutions, norms, and cultural beliefs. The analysis focuses on how genome editing is emerging in different domains and whether this marks (...) continuity or disruption of the established biotechnology regime. In conclusion, it will be argued that genome editing is best understood as a technology platform that is being powerfully shaped by this existing regime but is starting to disrupt the governance of biotechnology. In the longer term is it set to converge with other powerful technology platforms, which together will fundamentally transform the capacity to engineer life. (shrink)

In June 2020, Gilead agreed to provide the USA with 500 000 doses of remdesivir—an antiviral drug which at that time was percieved to show promise in reducing the recovery time for patients with COVID-19. This quantity represented Gilead’s then full production capacity for July and 90% of its capacity for August and September. Similar deals are evident around access to proposed vaccines for COVID-19, and such deals are only likely to increase. These attempts to secure preferential access to medicines (...) and vaccines, so-called vaccine/treatment nationalism, jeopardise supplies of life-saving treatments and vaccines available elsewhere, and jeopardise global equitable distribution of such vaccines/treatments more generally. Much of the focus to date has been on States’ role in negotiating such deals. However, such developments also demonstrate the power patent holders have in controlling access to life-saving healthcare, determining who obtains access first and at what price. This article argues that the extent of control currently given to patent holders for COVID-19 must be questioned. This article demonstrates that patents have significant implications for healthcare acting as private governance tools over patented inventions. It is only by greater probing of patent holders’ role in delivering access to medicines, diagnostics and vaccines for COVID-19 that equitable global equitable access can be achieved. (shrink)

Abstract: We examine how trustworthy behaviour can be achieved in the financial sector. The task is to ensure that firms are motivated to pursue long-term interests of customers rather than pursuing short-term profits. Firms’ self-interested pursuit of reputation, combined with regulation, is often not sufficient to ensure that this happens. We argue that trustworthy behaviour requires that at least some actors show a concern for the wellbeing of clients, or a respect for imposed standards, and that the behaviour of these (...) actors is copied in such a way that it becomes a behavioural norm. We briefly suggest what such behavioural norms might need to be if trustworthy behaviour is to be achieved, and consider how they might be supported; we describe the research that is necessary in order to understand these norms in more detail. We argue that the norms of traders are different from the norms of those engaged in other activities, since they are inevitably self-interested, and we consider the risk that traders’ norms might undermine those of other actors. We analyse the task for governance in dealing with this problem, and the role which leadership by a corporate board and management might play in doing this. We describe the need for further research in to describe how this might be done. (shrink)

This paper sets up and then solves a puzzle for the sceptical realist interpretation of Hume. The puzzle takes off when the sceptical realist attributes to Hume the following metaphysical theses: Causal powers grounding necessary connections in nature exist. Causal powers grounding necessary connections in nature are what make things happen.It then attributes an epistemological thesis to him: We have no knowledge of causal powers in nature nor of the necessary connections in nature which these powers ground.But putting these three (...) theses together seems to yield a problematic result. The epistemological thesis seems to have two corollaries as its upshot. We cannot know that causal powers grounding necessary connections in nature exist. We cannot know that causal powers grounding necessary connections in nature are what make things happen.That is, we cannot know and. New Hume’s position, the sceptical realist interpretation, seems to make Hume out to be arguing for a view that is self-undermining or dialectically unstable by his own empiricist lights. I argue that there is an overlooked externalist dimension to Hume’s epistemology and draw on this to solve the puzzle. (shrink)

CHAPTER ONE Augustine the Philosopher There are, according to Augustine in the early work entitled soliloquia, two principal (indeed, strictly speaking, ...

BackgroundWe review original papers on ovarian-hormone status in two areas of emotional processing: facial emotion recognition and emotional memory. Ovarian-hormone status is operationalized by the levels of the steroid sex hormones 17β-estradiol and progesterone, fluctuating over the natural menstrual cycle and suppressed under oral contraceptive use. We extend previous reviews addressing single areas of emotional processing. Moreover, we systematically examine the role of stimulus features such as emotion type or stimulus valence and aim at elucidating factors that reconcile the inconsistent (...) results.MethodsWe followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and included papers published until September 2020 indexed in PubMed and Web of Science databases. Search terms were MeSH terms AND AND with representing our separately searched areas, resulting in, and. To be included, articles had to be written and published in English, examine healthy, non-pregnant adult women in their reproductive age, and measure or at least estimate levels of E2 and P4. In PubMed, the search was limited to humans and to the search term present in the title or abstract.ResultsFeatures of the provided stimulus material constitute a relevant influence that interacts with E2- and P4-related ovarian-hormone status. For instance, recognition of basic emotions appears to be more related to P4- than E2-levels. Quite consistent, OC intake was accompanied by impaired recognition accuracy of basic and also complex emotions, although not in a recent large-sample study assessing complex emotions. Memory recall of negative content was mainly enhanced by P4, especially after having been stressed.Discussion and ConclusionWe document the methodological diversity in the field, presumably contributing to the heterogeneity of results. More studies explicitly contrasting the early follicular phase, mid-cycle phase, mid-luteal, and OC intake while standardizing tasks are needed. Research would take advantage of using within-subject designs and accounting for the recognition of complex emotions. (shrink)

We defend Joseph Melia's thesis that the role of mathematics in scientific theory is to ‘index’ quantities, and that even if mathematics is indispensable to scientific explanations of concrete phenomena, it does not explain any of those phenomena. This thesis is defended against objections by Mark Colyvan and Alan Baker.

Offers a comprehensive view of St Augustine's political ideas.

Background: Due to the important role of depression in major illnesses, screening measures for depression are commonly used in medical research. The protocol for managing participants with positive screens is unclear and raises ethical concerns. The aim of this article is to identify and critically discuss the ethical issues that arise when a positive screen for depression is detected, and offer some guidance on managing these issues.DiscussionDeciding on whether to report positive screens to healthcare practitioners is both an ethical and (...) a pragmatic dilemma. Evidence suggests that reporting positive depression screens should only be considered in the context of collaborative care. Possible adverse effects, such as the impact of false-positive results, potentially inappropriate labelling, and potentially inappropriate treatment also need to be considered. If possible, the psychometric properties of the selected screening measure should be determined in the target population, and a threshold for depression that minimises the rate of false-positive results should be chosen. It should be clearly communicated to practitioners that screening scores are not diagnostic for depression, and they should be informed about the diagnostic accuracy of the measure. Research participants need to be made aware of the consequences of the detection of high scores on screening measures, and to be fully informed about the implications of the research protocol.SummaryFurther research is needed and the experiences of researchers, participants, and practitioners need to be collated before the value of reporting positive screens for depression can be ascertained. In developing research protocols, the ethical challenges highlighted should be considered. Participants must be agreeable to the agreed protocol and efforts should be made to minimise potentially adverse effects. (shrink)

In his great poemThe Wreck of the DeutschlandGerard Manley Hopkins evokes the conversions of Paul and Augustine as two contrasting examples of the way in which God may intervene in human affairs:With an anvil-dingAnd with fire in him forge thy willOr rather, rather then, stealing as SpringThrough him, melt him but master him still:Whether at once, as once at a crash Paul,Or as Austin, a lingering-out sweet skill….

This article outlines and compares current and proposed global institutional mechanisms to increase equitable access to COVID-19 vaccines, focusing on their institutional and operational complementarities and overlaps. It specifically considers the World Health Organization's (WHO’s) COVAX (COVID-19 Vaccines Global Access) model as part of the Access to COVID-19 Tools Accelerator (ACT-A) initiative, the WHO’s COVID-19 Technology Access Pool (C-TAP) initiative, the proposed TRIPS (Trade-Related Aspects of Intellectual Property Agreement) intellectual property waiver and other proposed WHO and World Trade Organization technology (...) transfer proposals. We argue that while various individual mechanisms each have their specific individual merits—and in some cases weaknesses—overall, many of these current and proposed mechanisms could be highly complementary if used together to deliver equitable global access to vaccines. Nonetheless, we also argue that there are risks posed by the proliferation of proposals in this context, including the potential to disperse stakeholder attention or to delay decisive action. Therefore, we argue that there is now a clear need for concerted global multilateral action to recognise the complementarities of specific models and to provide a pathway for collaboration in attaining global equitable access to vaccines. The institutional infrastructure or proposals to achieve this amply exist at this point in time—but much greater cooperation from industry and clear, decisive and coordinated action from states and international organisations are urgently needed. (shrink)

Abstract: The notion of a self-pattern, as developed in the pattern theory of self, which holds that the self is best explained in terms of the kind of reality that pertains to a dynamical pattern, acknowledges the importance of neural dynamics, but also expands the account of self to extra-neural (embodied and enactive) dynamics. The pattern theory of self, however, has been criticized for failing to explicate the dynamical relations among elements of the self-pattern; as such, it seems to be (...) nothing more than a mere list of elements. We’ll argue that the dynamics of a self-pattern are reflected in three significant and interrelated ways that allow for investigation. First, a self-pattern is reflectively reiterated in its narrative component. Second, studies of psychiatric or neurological disorders can help us understand the precise nature of the dynamical relations in a self-pattern, and how they can fail. Third, referencing predictive processing accounts, neuroscience can also help to explicate the dynamical relations that constitute the self-pattern. (shrink)

Although environmental philosophy and the human exploration of space share common beginnings, scholars from either field have not given adequate attention to the possible connections between them. In this essay, we seek to spur the rapprochement and cross-fertilization of philosophy and space policy by highlighting the philosophic dimensions of space exploration, pulling together issues and authors that have had insufficient contact with one another. We do so by offering an account of three topics: planetary exploration, planetary protection and the search (...) for extraterrestrial life, and terraforming. The resulting synthesis seeks to change our thinking about earthbound environmental ethics as it considers the philosophical dimensions of space exploration, and introduces the possible benefits of a humanities-oriented approach to space policy. (shrink)

The eukaryotic cell is partitioned by membranes into spatially and functionally discrete subcellular organelles. In addition, the cytoplasm itself is partitioned into discrete subregions that carry out specific functions. Such compartmentation can be achieved by localizing proteins and RNAs to different subcellular regions. This review will focus on localized RNAs, with a particular emphasis on RNA localization mechanisms and on the possible biological functions of localization of these RNAs. In recent years, an increasing number of localized RNAs have been identified (...) in a variety of cell types among many animal species. Emphasis here will be on localized RNAs in the most intensively studied systems – Drosophila and Xenopus eggs and early embryos. (shrink)

In the Québécois political vision of the twentieth century, sovereignty became synonymous with mastery. French Canadians sometimes claimed solidarity with racialized and Indigenous peoples, yet they saw their liberation as a matter of taking their rightful place in the seat of the oppressors. The idea of mastery has prevented the Québécois from seeing that their liberation is bound up with that of other groups oppressed by colonial powers. The Eye of the Master confronts the missed opportunities for a decolonial version (...) of indépendance in Quebec by examining the quest for mastery that has been at the root of every version of independence offered to the people of Quebec since the mid-twentieth century. Exploring political discourse, popular culture, and the family photo album, Dalie Giroux revisits the mythology of being “masters in our own house” and identifies the obstacles blocking a more comprehensive version of liberation based on solidarity. Drawing from the living forces of Indigenous thought and anti-racist, ecological, and feminist movements, Giroux envisions life without conquest, domination, exploitation, and surveillance. Making the case for a different future, beginning in the here and now, The Eye of the Master offers a major new intervention in contemporary political thought to Canadian readers and all those who imagine a different North America. (shrink)

The science and technology of genetic testing is rapidly advancing with the consequences that genetic testing may well offer the prospect of being able to detect the onset of future disabilities. Some recent research also indicates that certain behavioural profiles may have a strong genetic basis, such as the determination to succeed and win or the propensity for risk-taking, which may be of interest to third parties. However, as this technology becomes more prevalent there is a danger that the genetic (...) information may be misused by entities such as employers, insurance companies, educational facilities, and finance companies and that people with particular genetic profiles may be discriminated against.This book explores the different types and the potential uses of genetic testing. The book highlights the ethical and legal dilemmas and the challenges arising as a result of emerging and rapidly advancing genetic science. Chapters in the book assess the importance and impact of the US Genetic Information Non-Discrimination Act (GINA) in the employment and health insurance contexts asking whether it is proving to be an effective tool in addressing the issue of genetic discrimination and alleviating individuals' fears of discrimination. The book then goes on to make the case for regulation at the European Union level in order to protect the privacy of genetic information and to prevent the discriminatory use of genetic information in Europe. It considers what can be learnt from the experience of the US in addressing ethical and legal issues as well as the impact that the UN Convention on the Rights of Persons with Disabilities is having on this debate within the EU. (shrink)

The application of machine learning and artificial intelligence in healthcare domains has received much attention in recent years, yet significant questions remain about how these new tools integrate into frontline user workflow, and how their design will impact implementation. Lack of acceptance among clinicians is a major barrier to the translation of healthcare innovations into clinical practice. In this systematic review, we examine when and how clinicians are consulted about their needs and desires for clinical AI tools. Forty-five articles met (...) criteria for inclusion, of which 24 were considered design studies. The design studies used a variety of methods to solicit and gather user feedback, with interviews, surveys, and user evaluations. Our findings show that tool designers consult clinicians at various but inconsistent points during the design process, and most typically at later stages in the design cycle. We also observed a smaller amount of studies adopting a human-centered approach and where clinician input was solicited throughout the design process. A third of all studies reported on clinician trust in clinical AI algorithms and tools. The surveyed articles did not universally report validation against the “gold standard” of clinical expertise or provide detailed descriptions of the algorithms or computational methods used in their work. To realize the full potential of AI tools within healthcare settings, our review suggests there are opportunities to more thoroughly integrate frontline users’ needs and feedback in the design process. (shrink)

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

In recent decades, neo-republican philosophers have developed a theory of freedom as non-domination, which, they claim, is conceptually and analytically distinct from the “liberal” concept of freedom as non-interference. However, neo-republicans have intervened in constitutional debate almost exclusively in relation to structural issues of institutional competence, and have made little impact on the analytical jurisprudence of constitutional rights. While judicial review seems ill equipped to respond to the distributive dimensions of republican freedom, republicans like Richard Bellamy have argued that the (...) whole edifice of countermajoritarian, strong-form judicial review is itself an affront to freedom as non-domination properly understood. Republican freedom, in this lens, is defined structurally, procedurally and politically rather than in relation to a definite set, concept or theory of rights that is put outside and beyond politics. And partly for this reason, there has been little commentary concerning how the theory of freedom as non-domination might inform constitutional-rights doctrine. This article will argue, first, that the neo-republican view can usefully inform constitutional-rights doctrine notwithstanding republican reservations concerning judicial power. Second, it will propose a number of specific ways in which the jurisprudence of constitutional rights might account for the central concerns of the republican idea. (shrink)

Thomas Hofweber argues that the thesis of direct reference is incompatible with physicalism, the claim that the nonphysical supervenes on the physical. According to Hofweber, direct reference implies that some physical objects have object-dependent properties, such as being Jones’s brother, which depend on particular objects for their existence and identity. Hofweber contends that if some physical objects have object-dependent properties, then Local-Local Supervenience (the physicalist doctrine on which he concentrates) fails. In this note, we argue that Hofweber has failed to (...) show that the possession by physical objects of object-dependent properties implies the falsity of Local-Local Supervenience. (shrink)

Chris Daly; Tropes, Proceedings of the Aristotelian Society, Volume 94, Issue 1, 1 June 1994, Pages 253–262, https://doi.org/10.1093/aristotelian/94.1.253.

Reply to article 'Political Perception and Ensemble of Macro Objectives and Measures: The Paradox of the Index for Sustainable Economic Welfare' by Rafael Ziegler in Environmental Values vol.16 no.1, pp.43-60.

J’élaborerai dans ce texte une interprétation de la pensée politique de Negri en tant qu ‘elle est geste, et que je formule de la manière suivante: (1) La pensée politique d’Antonio Negri est principalement, dans son effet le plus important et le plus immédiat, et dans son intention même, thérapeutique ; (2) Une telle lecture permet d’élucider dans cette pensée politique un certain nombre de paradoxes apparents, notamment la question de I’immanence et de la révolution ; (3) Ce geste thérapeutique (...) de transvaluation ontologique relève, à plusieurs égards, d’un mode d’action symbolique qui peut se comprendre comme paradigme de la créativité matérielle et symbolique caracteristique d’une certaine philosophie politique émancipatrice que I’on retrouve chez Socrate, Jésus de Nazareth et Étienne de la Boétie. (shrink)

J’élaborerai dans ce texte une interprétation de la pensée politique de Negri en tant qu ‘elle est geste, et que je formule de la manière suivante: (1) La pensée politique d’Antonio Negri est principalement, dans son effet le plus important et le plus immédiat, et dans son intention même, thérapeutique ; (2) Une telle lecture permet d’élucider dans cette pensée politique un certain nombre de paradoxes apparents, notamment la question de I’immanence et de la révolution ; (3) Ce geste thérapeutique (...) de transvaluation ontologique relève, à plusieurs égards, d’un mode d’action symbolique qui peut se comprendre comme paradigme de la créativité matérielle et symbolique caracteristique d’une certaine philosophie politique émancipatrice que I’on retrouve chez Socrate, Jésus de Nazareth et Étienne de la Boétie. (shrink)